JAMA neurology最新文献

{"title":"Gantenerumab in Dominantly Inherited Alzheimer Disease-Reply.","authors":"Olivia Wagemann, Eric McDade, Randall J Bateman","doi":"10.1001/jamaneurol.2024.3828","DOIUrl":"10.1001/jamaneurol.2024.3828","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"111-112"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAMA Neurology.","authors":"","doi":"10.1001/jamaneurol.2024.3408","DOIUrl":"https://doi.org/10.1001/jamaneurol.2024.3408","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"82 1","pages":"4"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Results.","authors":"","doi":"10.1001/jamaneurol.2024.4836","DOIUrl":"10.1001/jamaneurol.2024.4836","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"82 1","pages":"112"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deferiprone in Alzheimer Disease: A Randomized Clinical Trial.","authors":"Scott Ayton, David Barton, Bruce Brew, Amy Brodtmann, Roger Clarnette, Patricia Desmond, David Devos, Kathryn A Ellis, Amir Fazlollahi, Caroline Fradette, Anita M Y Goh, Pawel Kalinowski, Christopher Kyndt, Rosalyn Lai, Yen Ying Lim, Paul Maruff, Terence J O'Brien, Christopher Rowe, Olivier Salvado, Peter W Schofield, Michael Spino, Fernando Tricta, Aaron Wagen, Robert Williams, Michael Woodward, Ashley I Bush","doi":"10.1001/jamaneurol.2024.3733","DOIUrl":"10.1001/jamaneurol.2024.3733","url":null,"abstract":"<p><strong>Importance: </strong>Interventions that substantially slow neurodegeneration are needed to address the growing burden of Alzheimer disease (AD) to societies worldwide. Elevated brain iron observed in AD has been associated with accelerated cognitive decline and may be a tractable drug target.</p><p><strong>Objective: </strong>To investigate whether the brain-permeable iron chelator deferiprone slows cognitive decline in people with AD.</p><p><strong>Design, setting, and participants: </strong>This phase 2, double-masked, placebo-controlled randomized clinical trial of 12-month duration was conducted at 9 sites in Australia between August 2, 2018, and April 1, 2023. Patients older than 54 years with amyloid-confirmed mild cognitive impairment or early AD (a Mini-Mental State Examination score of 20 or higher) were screened. Randomization was 2:1 and masked to participants and all study staff.</p><p><strong>Interventions: </strong>Deferiprone 15 mg/kg twice a day or placebo administered orally for 12 months.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was a composite cognitive measure assessed at baseline, 6 months, and 12 months using a neuropsychological test battery (NTB) of memory, executive function, and attention tasks. Secondary outcomes included change in brain iron burden measured by quantitative susceptibility mapping (QSM) magnetic resonance imaging (target engagement), brain volume changes (secondary efficacy measure), and adverse events (safety analysis).</p><p><strong>Results: </strong>Of 167 patients screened for eligibility, 81 were included, with 53 randomly assigned to the deferiprone group (mean [SD] age, 73.0 [8.0] years; 29 male [54.7%]) and 28 to the placebo group (mean [SD] age, 71.6 [7.2] years; 17 male [60.7%]); 54 participants completed the study (7 [25.0%] withdrew from the placebo group and 20 [37.7%] from the deferiprone group). In an intention-to-treat analysis, participants in the deferiprone group showed accelerated cognitive decline on the NTB primary outcome (β for interaction = -0.50; 95% CI, -0.80 to -0.20) compared with placebo (change in NTB composite z score for deferiprone, -0.80 [95% CI, -0.98 to -0.62]; for placebo, -0.30 [95% CI, -0.54 to -0.06]). Secondary analysis revealed that this result was driven by worsening performance on executive function tests. The QSM confirmed that deferiprone decreased iron in the hippocampus compared with placebo (change in hippocampal QSM for deferiprone, -0.36 ppb [95% CI, -0.76 to 0.04 ppb]; for placebo, 0.32 ppb [95% CI, -0.12 to 0.75 ppb]; β for interaction = -0.68 [95% CI, -1.27 to -0.09]). Longitudinal hippocampal volume loss was not affected by deferiprone, but exploratory analysis of other brain regions revealed increased volume loss with deferiprone in frontal areas. The frequency of the adverse effect of neutropenia (4 participants [7.5%] in the deferiprone group) was higher than in similar studies (1.6%-4.4%).</p><p><strong>C","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"11-18"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate or Delayed Statin in Acute Atherosclerotic Ischemia-Reply.","authors":"Ying Gao, Yuesong Pan, Yilong Wang","doi":"10.1001/jamaneurol.2024.3750","DOIUrl":"10.1001/jamaneurol.2024.3750","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"110-111"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remembering the Physician's Humanity-Physicians Are Humans Too.","authors":"Noriko Anderson","doi":"10.1001/jamaneurol.2024.3744","DOIUrl":"10.1001/jamaneurol.2024.3744","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"9-10"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gantenerumab in Dominantly Inherited Alzheimer Disease.","authors":"Nunzio Pomara, Bruno Pietro Imbimbo","doi":"10.1001/jamaneurol.2024.3825","DOIUrl":"10.1001/jamaneurol.2024.3825","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"111"},"PeriodicalIF":20.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mood Alterations in the Prodromal Phase of Sporadic Creutzfeldt-Jakob Disease","authors":"Raphael Wurm, Sigrid Klotz, Astrid Erber, Felix Gruber, Stefan Leitner, Berthold Reichardt, Elisabeth Stögmann, Eva Schernhammer, Ellen Gelpi, Hakan Cetin","doi":"10.1001/jamaneurol.2024.4447","DOIUrl":"https://doi.org/10.1001/jamaneurol.2024.4447","url":null,"abstract":"ImportanceSporadic Creutzfeldt-Jakob disease (sCJD) is a rare, rapidly progressive and fatal neurodegenerative disease. Definite sCJD diagnosis can only be made post mortem, and little is known about the prodromal phase of the disease.ObjectiveTo compare drug prescription patterns before the clinical onset of sCJD between patients and matched controls for exploration of potential risk factors and to assess correlations between drug exposure and sCJD survival.Design, Setting, and ParticipantsThis retrospective analysis was designed as a case-control study, with data collected from January 2013 to December 2020 and analyzed in 2023. Follow-up was available until December 2020. Cases were collected from the Austrian Reference Centre for Human Prion Diseases, which receives all suspected cases at a national level in Austria. The analyses were conducted at a single center. Patients with autopsy-confirmed sCJD were linked with insurance claims data, and a minimum of 10 control individuals were matched by sex, age at onset, and area of residence for each patient with sCJD.ExposureMedication prescribed to 10% or more of the cohort with sCJD up to 5 years before symptom onset or the matching date in the control cohort.Main Outcomes and MeasuresDrug prescription before symptom onset or the matching date was compared between patients with sCJD and controls using conditional regression, and prescriptions in the cohort with sCJD were assessed for correlation with survival using Cox proportional hazard models.ResultsA total of 129 patients with sCJD (median [IQR] age, 68.9 [62.4-75.5] years; 67 female [51.9%]) and 1350 controls (median [IQR] age, 69.0 [62.2-75.3] years; 700 female [51.9%]) were included. As compared with controls, patients with sCJD were found to have significantly higher odds of being prescribed selective serotonin reuptake inhibitors (SSRIs) in the year preceding disease onset (odds ratio, 2.86; 95% CI, 1.63-4.95; <jats:italic>P</jats:italic> &amp;amp;lt; .001). SSRI prescription rates started to increase 3 years before symptom onset in the cohort with sCJD.Conclusions and RelevanceResults of this case-control study provide evidence for prodromal mood alterations as early as 3 years before symptom onset in patients with sCJD. Although sCJD remains an extremely rare cause of mood alterations, increased vigilance for neurodegenerative diseases in this setting could eventually help to extend the diagnostic window.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"164 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heatwaves and Neurodegenerative Disease.","authors":"Indu Subramanian, Ali Saad","doi":"10.1001/jamaneurol.2024.4319","DOIUrl":"https://doi.org/10.1001/jamaneurol.2024.4319","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Portal Messaging Crisis.","authors":"Carrie K Grouse, Gregory J Esper","doi":"10.1001/jamaneurol.2024.4153","DOIUrl":"https://doi.org/10.1001/jamaneurol.2024.4153","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}